ELENA NGUYEN
Dependent on policy B07M000588
Claims
1
Attributed to this person
Charged
267.00
Total submitted
Denied
267.00
1 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | ELENA NGUYEN |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000588 |
| Date of birth | 12 Jan 2014 |
| Plan | PLATINUM PPO |
| Covered from | 29 Jun 2024 |
| Covered to | 8 Dec 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002487 | 12 Oct 2024 | 267.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 267.00 |